Bone-block iliotibial band reconstruction for anterior cruciate insufficiency. Follow-up note and minimum five-year follow-up period.
Sixty-two of 71 patients (87%) who received a bone-block iliotibial band transfer were followed with a minimum follow-up period of five years (range, 5-10 years). Sixteen of the originally studied knees were examined with an average follow-up period of 104 months (range, 90-120 months). A second group of 46 knees was studied at an average follow-up period of 75 months (range, 60-92 months). Preoperatively, all patients had giving way (buckling). The average postoperative score of the original group was 83 (range, 52-99 points). There were nine excellent, three good, and four poor results. The average postoperative score of the second group was 89 (range, 73-99 points). There were 24 excellent, 18 good, and four fair results. Giving way was absent in 93% of the patients postoperatively; 88% had a negative pivot-shift test. Sixty-eight percent of the patients no longer used a brace for sports, 24% wore a brace for protection only, and 8% used it for instability. Improvement of at least one grade in the Lachman and anterior drawer tests was found in 61% and 85% of the patients, respectively. Pain was the major reason for fair and poor results. All but one had previous meniscectomy. There were no fair or poor results with menisci intact. So far, there has been no deterioration with time. The procedure remains ideal for recreational athletes who cannot afford a long absence from work and for those patients whose daily activities are compromised by recurrent knee instability.
Windsor
R E
RE
Hospital for Special Surgery, New York, New York 10021.
Insall
J N
JN
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D005206:Fascia Lata / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D009068:Movement; D005082:Physical Exertion; D011183:Postoperative Complications; D012086:Reoperation; D013977:Tibia / Q000601:surgery